Description - DE Medical Assistance Program

L2265 LONG TONGUE STIRRUP 3 $84.55
L2270 VARUS/VALGUS STRAP PADDED/LI 3 $39.65
L2275 PLASTIC MOD LOW EXT PAD/LINE 3 $93.48
L2280 MOLDED INNER BOOT 3 $326.87
L2300 ABDUCTION BAR JOINTED ADJUST 3 $204.94
L2310 ABDUCTION BAR-STRAIGHT 3 $102.64
L2320 NON-MOLDED LACER 3 $147.73
L2330 LACER MOLDED TO PATIENT MODE 3 $309.23
L2335 ANTERIOR SWING BAND 3 $190.92
L2340 PRE-TIBIAL SHELL MOLDED TO P 3 $413.33
L2350 PROSTHETIC TYPE SOCKET MOLDE 3 $713.86
L2360 EXTENDED STEEL SHANK 3 $37.15
L2370 PATTEN BOTTOM 3 $240.71
L2375 TORSION ANK & HALF SOLID STI 3 $101.69
L2380 TORSION STRAIGHT KNEE JOINT 3 $88.39
L2385 STRAIGHT KNEE JOINT HEAVY DU 3 $96.17
L2387 ADD LE POLY KNEE CUSTOM KAFO 6 $0.00
L2390 OFFSET KNEE JOINT EACH 3 $80.51
L2395 OFFSET KNEE JOINT HEAVY DUTY 3 $112.34
L2397 SUSPENSION SLEEVE LOWER EXT 3 $87.53
L2405 KNEE JOINT DROP LOCK EA JNT 3 $65.34
L2415 KNEE JOINT CAM LOCK EACH JOI 3 $91.03
L2425 KNEE DISC/DIAL LOCK/ADJ FLEX 3 $107.43
L2430 KNEE JNT RATCHET LOCK EA JNT 3 $107.43
L2435 KNEE JOINT POLYCENTRIC JOINT O $0.00
L2492 KNEE LIFT LOOP DROP LOCK RIN 3 $97.54
L2500 THI/GLUT/ISCHIA WGT BEARING 3 $233.34
L2510 TH/WGHT BEAR QUAD-LAT BRIM M 3 $523.55
L2520 TH/WGHT BEAR QUAD-LAT BRIM C 3 $345.37
L2525 TH/WGHT BEAR NAR M-L BRIM MO 3 $931.80
L2526 TH/WGHT BEAR NAR M-L BRIM CU 3 $531.72
L2530 THIGH/WGHT BEAR LACER NON-MO 3 $168.70
L2540 THIGH/WGHT BEAR LACER MOLDED 3 $303.55
L2550 THIGH/WGHT BEAR HIGH ROLL CU 3 $206.21
L2570 HIP CLEVIS TYPE 2 POSIT JNT 3 $341.99
L2580 PELVIC CONTROL PELVIC SLING 3 $333.23
L2600 HIP CLEVIS/THRUST BEARING FR 3 $182.48
L2610 HIP CLEVIS/THRUST BEARING LO 3 $193.28
L2620 PELVIC CONTROL HIP HEAVY DUT 3 $217.32
L2622 HIP JOINT ADJUSTABLE FLEXION 3 $246.37
L2624 HIP ADJ FLEX EXT ABDUCT CONT 3 $237.76
L2627 PLASTIC MOLD RECIPRO HIP & C 3 $1,297.39
L2628 METAL FRAME RECIPRO HIP & CA 3 $1,276.17
L2630 PELVIC CONTROL BAND & BELT U 3 $177.79
L2640 PELVIC CONTROL BAND & BELT B 3 $241.29
L2650 PELV & THOR CONTROL GLUTEAL 3 $102.75
L2660 THORACIC CONTROL THORACIC BA 3 $133.82
L2670 THORAC CONT PARASPINAL UPRIG 3 $129.79
L2680 THORAC CONT LAT SUPPORT UPRI 3 $120.23